唾液生物标志物在类风湿关节炎诊断和预后评估中的潜力：一项系统评价与荟萃分析：类风湿关节炎患者的唾液生物标志物——一项系统评价与荟萃分析
Potential of salivary biomarkers for diagnosing and prognosing rheumatoid arthritis: A systematic review and meta-analysis: Salivary biomarkers in Rheumatoid Arthritis patients - A systematic review with Meta-analysis.
作者信息
Pandarathodiyil Anitha Krishnan, Kasirajan Hema Shree, Vemuri Suresh, Sujai G V Naga Sai, B Sivapathasundharam, Ramadoss Ramya
机构信息
Faculty of Dentistry, SEGi University, Kota Damansara, 47810 Petaling Jaya, Selangor, Malaysia.
Department of Oral and Maxillofacial Pathology, Saveetha Dental College and Hospitals, Saveetha Institute Medical and Technical Science, Saveetha University, Chennai, India; Department of Oral Biology, Saveetha Dental College and Hospitals, Saveetha Institute Medical and Technical Science, Saveetha University, Chennai, India.
出版信息
J Stomatol Oral Maxillofac Surg. 2025 Mar;126(2):102074. doi: 10.1016/j.jormas.2024.102074. Epub 2024 Sep 12.
BACKGROUND
Rheumatoid arthritis (RA) is a chronic debilitating autoimmune disorder. Blood biomarkers, like rheumatoid factor (RF) and anti-citrullinated protein antibodies (ACPAs), lack the sensitivity and specificity for early diagnosis, delaying treatment. This review while highlighting the need for new diagnostic tools, emphasizes the promising avenue of saliva for developing RA biomarkers.
OBJECTIVE
This systematic review and meta-analysis assess the effectiveness of salivary biomarkers in the diagnosis and prognosis of RA, examining current evidence and proposing avenues for future research.
METHODOLOGY
A literature review following PRISMA 2021 guidelines was conducted using PubMed, Scopus, Web of Science, and Google Scholar to identify studies from the past five years on salivary biomarkers in RA patients compared to healthy controls.
RESULT
The review focused on original research articles, and meta-analysis was performed on studies reporting standard deviation values for inflammatory markers such as IL-6, IL-8, MMP-8, and TNF-alpha. The meta-analysis included eleven studies with 394 RA patients and 255 healthy controls, evaluating IL-8, IL-6, MMP-8, and TNF-α as RA biomarkers. IL-8 showed a mean difference of 7.32 (CI: -5.48 to 20.13), not statistically significant, favouring controls. IL-6 had a CI of -0.09 (CI: -2.20 to 2.02) with high heterogeneity (I² = 98%), suggesting its potential as a diagnostic and prognostic biomarker. TNF-α and MMP-8 showed no significant differences (CIs: 4.54 and 2.71, respectively).
CONCLUSION
This systematic review and meta-analysis emphasize saliva's potential in identifying RA biomarkers, especially IL-6, which is associated with the disease's pathogenesis. However, significant evidence heterogeneity necessitates larger, multicentric studies for validation.
背景
类风湿性关节炎（RA）是一种慢性致残性自身免疫性疾病。血液生物标志物，如类风湿因子（RF）和抗瓜氨酸化蛋白抗体（ACPA），缺乏早期诊断的敏感性和特异性，导致治疗延迟。本综述在强调需要新的诊断工具的同时，强调了唾液在开发RA生物标志物方面的有前景的途径。
目的
本系统综述和荟萃分析评估唾液生物标志物在RA诊断和预后中的有效性，审查当前证据并提出未来研究的途径。
方法
按照PRISMA 2021指南进行文献综述，使用PubMed、Scopus、科学网和谷歌学术搜索过去五年中关于RA患者唾液生物标志物与健康对照相比的研究。
结果
该综述聚焦于原创研究文章，并对报告炎症标志物如IL-6、IL-8、MMP-8和TNF-α标准差数值的研究进行荟萃分析。荟萃分析纳入了11项研究，共394例RA患者和255例健康对照，评估IL-8、IL-6、MMP-8和TNF-α作为RA生物标志物。IL-8显示平均差异为7.32（CI：-5.48至20.13），无统计学意义，倾向于对照。IL-6的CI为-0.09（CI：-2.20至2.02），异质性高（I² = 98%），表明其作为诊断和预后生物标志物的潜力。TNF-α和MMP-8无显著差异（CI分别为4.54和2.71）。
结论
本系统综述和荟萃分析强调了唾液在识别RA生物标志物方面的潜力，特别是IL-6，它与疾病的发病机制相关。然而，显著的证据异质性需要更大规模的多中心研究进行验证。
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